The State of LGBT Health—Minus the “T”

This week, the District Mayor's Office of GLBT Affairs released the "LGB Health 2010 Report," an examination of everything from smoking habits to sexual behavior in the gay community. This is the District's first report to address the health of lesbians, gays, and bisexuals in the District. But as the report's title makes clear, the transgender community has yet again been excluded from the official conversation on health. Also underrepresented here: African-American men and women under the LGB umbrella.

But first, the findings: The report surveyed 6,218 District residents—90 percent identifying as heterosexual, 4.5 percent identifying as gay or lesbian, and 2.3 percent identifying as bisexual or "other"—from 2005 to 2007.

According to the report, gay, lesbian, and bisexual District residents are more likely to rate their health as "good" or better; more likely to smoke; more likely to binge drink; more likely to be "neither overweight or obese"; more likely to "report one or more days of bad mental health"; more likely to "engage in risky behavior for contracting HIV"; more likely to exercise; more likely to take HIV tests; and more likely to be white.

The methodology of the [study] itself raises questions about the reliability of the data and how it represents the true health of the LGB community, as reflected by the limited number of responses from African American LGBT people. The survey's findings rely on an identity-based rather than a behavioral questionnaire, which may exclude men who have sex with other men (MSM) but do not identify as gay.

The report also fails to differentiate between data for gays and lesbian respondents. According to the report, "8.3% of male respondents self identified as gay," while only "2.0% of female respondents self identified as lesbian." It is unlikely, for example, that lesbians are engaging in "risky behavior for contracting HIV" at the rates that gay men are—so what's the benefit in lumping the demographics together?

And, as always: "the absence of information on transgender health underscores the pressing need for better data on the transgender community in the District," the DC Center writes.

It would be interesting to know what percentage of DC residents identify as transgender. However if you surveyed 6,218 random residents I think you would not get a sample large enough to make any meaningful statements about transgender health.

What would your guess be as to how man transgender men and transgender women there are in DC?

The incidence is a hotly debated topic. The DSM says "1 in 30,000 assigned males and 1 in 100,000 assigned females seek sex reassignment surgery in the USA". Others estimate as high as 1 in 500 people are transgender. Even considering that DC's population percent would probably be much higher (it is unlikely that transgender people would remain in rural America) at the lower rate a random sample of less than 10 thousand people would not give results at an acceptable confidence level.

I suspect one reason this isn't even asked is how long it would take to even explain what the transgender is to a large percent of the population.

http://www.washingtoncitypaper.com/blogs/sexist Amanda Hess

Hey Charlie, Whitman-Walker has told me that it treats several hundred trans patients, and the 2000 Transgender Needs Assessment surveyed 250 D.C. trans people. I'm guessing that these numbers are probably more likely to include local people who identify as trans and are actually out, living (at least some of the time) as their gender identity.

Charlie

Thanx.

Any meaningful information on transgender health issues could not be obtained from this type of survey. The sample size is too small.

No breakdown of the LGB population by race or gender is a larger flaw but that is no doubt also due to sample size. If only 2% of those surveyed were Lesbians then in raw number terms that would be about 65 responses. For race where only 2% of the African-Americans identified as gay this might be more in the range of 130-180 responses. With numbers so low you cannot make conclusion with any confidence.

While it might be satisfying to criticize the Mayor's Office of LGBT Affairs for this the reality is that having ANY report on gay health needs is progressive. No doubt they had to fight to get a question about sexual orientation included in this survey. It would be hoped the the DOH recognizes that such survey are valuable and also the need to increase the sample size in future years.

It will be interesting to see how this story gets covered on the blogs and stuff. After all, Chris Dyer's job is on the line if Fenty loses the election. Will it be "first ever DC health survey to include gay people" or "transgender left out of picture"? My impression is that the transgender community does not think Chris Dyer is a fierce enough advocate for their interests. Of course, you can count on one finger the number of trangender people I have any regular contact with so that is not very statistically significant.

http://www.washingtoncitypaper.com/blogs/sexist Amanda Hess

Charlie: Agreed that this is a good step forward. Since the latest data comes from 2007, it's clear that this stuff doesn't move at a blogger's pace, but I do also hope that in the future these weak spots are taken into consideration, so it's important to point them out now.

Better data on lesbian and transgender locals may require a larger sample size or a more targeted approach. Information about African-American LGBT residents is going to take something different. The DC Center isn't criticizing this report for failing to separate out data for African-American LGBs, but rather for framing questions in a way that is more likely to cater to white conceptions of LGB than African-American ones.

kza

How is white gay different from black gay?

http://rickmangus@aol.com Rick Mangus

This message is brought to you by the morons at the District Department of Health, WOW!, I fell safe and secure already!

http://www.thedccenter.org David Mariner

Hey Amanda,

Just wanted to say thank you for all your recent blog posts on LGBT and HIV/AIDS issues. I think you're doing a great job and just wanted to say so.

Best,

David Mariner
The DC Center

dj bent

thanks for this amanda, and the interesting comments from charlie. i actually think it's good that they separated LGB from T - since trans people can also be L, G, B or straight (or some other identity). on the other hand, some trans folks link their transgender identity very clearly to being "gay" or "homosexual" while others see the two as quite different (just b/c i am trans does not mean i am gay, or straight, as some people say). i think the district badly needs a new transgender needs assessment (and one that fully includes folks in the FTM spectrum), even if it is not statistically perfect as charlie points out.